Impact of a service-learning course on first-year pharmacy students' learning outcomes

Impact of service-learning placement on pharmacy student knowledge, attitudes, and confidence in helping patients navigate Medicare Part D

INTRODUCTION

Pharmacists are in a prime position to empower patients to navigate Medicare Part D. This study aimed to determine if service-learning has a place in pharmacy student Medicare education. The primary objective of the study was to assess knowledge, attitudes, and confidence of first-year pharmacy students at Medicare focused service-learning sites compared to students at alternative sites.

METHODS

First-year pharmacy students at the University of Pittsburgh School of Pharmacy were assessed on their knowledge, attitudes, and confidence of Medicare Part D after a semester of service-learning either at a State Health Insurance Assistance Program (SHIP) or at an alternative site not focused on Medicare (control). All students attended a four-part lecture series on Medicare before starting service-learning. Students were surveyed at baseline and after their service-learning experience.

RESULTS

A total of 110 (94.8%) students successfully completed both the pre- and post-survey. Knowledge improved significantly in the SHIP group (P = .01) and did not increase significantly in the control group (P = .06). Attitudes toward Medicare Part D, assessed on a Likert scale, became less favorable in the control group (-0.40, P < .001). Student confidence in the ability to counsel patients on Medicare part D improved in the SHIP group (0.42, P < .001) and decreased in the control group (-0.80, P < .001).

CONCLUSIONS

Combining a didactic lecture series on Medicare Part D with service-learning involving Medicare counseling may solidify student knowledge of Medicare as well as students' confidence in helping patients navigate Medicare Part D.

Fostering empathy and self-efficacy in pharmacy students through service learning

BACKGROUND

Pharmacy student proficiency in direct patient interactions is an integral component of the doctor of pharmacy curriculum. Service-learning experiences offer pharmacy students valuable opportunities to develop self-efficacy and empathy while serving communities with unmet needs. The objective of this review is to evaluate the impact of service-learning experiences on the self-efficacy and empathy of pharmacy and other health professions students.

METHODS

A narrative literature review was conducted using PubMed, ERIC, and CINAHL databases. Articles were included if they described the relationship between any health professions student service-learning experience and changes in self-efficacy and empathy. Articles were excluded if they involved simulation experiences, standardized patients, or international experiences.

RESULTS

A total of 11 relevant articles were identified, seven examined changes in student self-efficacy and six assessed student empathy. Articles included students representing seven health professions, with one eligible article in pharmacy. All articles investigating self-efficacy reported a positive impact of service learning on student confidence. Most articles focusing on empathy found that service learning had a positive impact on student empathy, and only one article noted a negative trend. Students with limited prior direct patient care experience had the greatest improvement in clinical confidence and empathy.

IMPLICATIONS

This review adds a new perspective to the literature by evaluating evidence-based service-learning models in pharmacy education. Offering additional structured service-learning opportunities for pharmacy students fosters self-efficacy and empathy while supporting communities with unmet needs. Future studies evaluating innovative service-learning models and methods of continuous assessment within the pharmacy curriculum are warranted.

Exploring Factors That Influence Student Engagement in Community-Engaged Learning Activities Within a Pharmacy Context

Objective. To investigate and identify factors that enhance and restrict Doctor of Pharmacy student engagement in mandatory and voluntary community-engaged learning activities.Methods. A phenomenological study exploring the motivations and barriers faced by pharmacy students in a mandatory community-engaged learning course and voluntary community-engaged learning activities (eg, community outreach) was conducted using semi-structured interviews. Fifteen students were randomly selected to participate in the interviews. Student responses were analyzed using qualitative thematic analysis.Results. Primary factors motivating student engagement in mandatory community-engaged learning included having structured learning activities for students and incorporating reflective learning. Motivating factors for students participating in voluntary community-engaged learning included personal interest in the topic, convenient location and time of activity, opportunity for career development, and the chance to advocate for the pharmacy profession. Overlapping motivations for both mandatory and voluntary community-engaged learning included developing a better understanding of and broader perspective on the diverse populations in the community and having a positive impact. Common barriers identified included having limited information about student responsibilities, being given a limited student role, and feeling unconfident or unprepared.Conclusion. Students perceived benefits from both mandatory and voluntary participation in community-engaged learning activities. However, opportunities exist for identifying and managing barriers to enhancing student engagement in community-engaged learning within a pharmacy program. Additionally, learning tools such as critical reflection can be used to further enhance student engagement with community-engaged learning activities.

Clinical Pharmacists' Knowledge of and Attitudes toward Older Adults

Background: Although pharmacy literature suggests that pharmacists have a positive attitude towards older adults, there is a paucity of studies that have measured pharmacists’ knowledge or attitudes towards older people. The purpose of our study was to assess the knowledge and attitudes of hospital pharmacists toward older adults. Methods: An electronic survey was distributed over two months to clinical hospital pharmacists across the province of Alberta, Canada. The survey was composed of two validated tools, the Palmore Facts of Aging Quiz (PFAQ) and Kogan’s Attitude toward Old People Scale (KOPS). PFAQ is scored from 0 (poor knowledge) to 25 (high knowledge) and KOPS from 34 to 204, with higher than 119 indicating a positive attitude. Results: A total of 153 pharmacists completed the survey (response rate of 24%). The mean age was 39 (SD 10.8) years; the average years practiced was 15 (SD 11), and the majority of respondents (n = 65) reported that >50% of patients in their practice were geriatrics. The mean correct responses on the PFAQ were 18.8 (SD 2.6). KOPS had a mean score of 156.8 (SD 14), with only one pharmacist score falling below 119, indicating a negative attitude. There was a statistically significant, positive correlation between attitudes and knowledge (r = 0.38, p < 0.05), as well as the increasing age of the respondents (r = 0.18, p = 0.03). The remaining measured categories (i.e., gender, years of pharmacy practice) had no significant effect. Conclusion: Clinical hospital pharmacists in Alberta have a positive attitude toward geriatric patients, as well as a satisfactory knowledge of older adults.

Student Pharmacists' Perspectives on Service-Learning Experiences in Free Clinics

Objective. To explore student pharmacists' perspectives on the value of pharmacy-related service-learning experiences focused on caring for underserved populations. Methods. Student pharmacists were required to complete a three-hour volunteer experience at a free clinic in western Pennsylvania. Reflective essays from all second- and third-year student pharmacists who participated in the required service-learning experience were deidentified. Essays were thematically analyzed to formulate a list of codes that represent dominant conceptual categories. Two independent coders read and coded all essays submitted from September 2015 to May 2017 using qualitative data analysis. Codes were evaluated for intercoder variability and discrepancies were mediated through discussion. Results. Four hundred twenty-two students submitted reflective essays: 222 essays were submitted by second-year students and 200 by third-year students. The prevailing themes reflected the professional obligation students felt to provide care to the underserved, empathy for underserved patients, perspectives on equitable health resource distribution, the value of service-learning experiences, growth in interprofessional awareness, and self-reported empowerment from the experience. Themes were consistent in the reflective essays of both second-year and third-year students. Third-year students' essays reflected a greater sense of self-assurance and confidence in their role at the free clinics. Students made connections between their didactic learning and experiential education. Conclusion. Student pharmacists valued their experiences working in underserved settings. Free clinics provide opportunities for student pharmacists to develop hands-on training as well as gain a broader perspective on underserved populations, health resource distribution, and the role of pharmacists.

Implementation of a Student-Developed, Service-Based Internship for Pharmacy Students

PURPOSE

This article describes the development, implementation, and impact of a student-created pharmacy internship program with aspects of service-learning, professional development, and ambulatory care pharmacy practice.

PROGRAM DESCRIPTION

As the pharmacy profession continues to evolve, pharmacy internships present valuable opportunities for student pharmacists to explore career pathways and develop personal and professional skills. While internships in clinical and industry settings support interns' professional development, service-based internships provide additional benefits to student pharmacists by promoting cultural awareness, community engagement, and commitment to serving underserved patients. Student leaders from the Student Health Action Coalition (SHAC) at the University of North Carolina Eshelman School of Pharmacy created a service-learning, ambulatory carefocused pharmacy internship for fellow student pharmacists. Two rising third-year students were selected to participate in the internship in the summer of 2018. Over the two-month program, the interns participated in various program components including direct patient care activities, faculty-led workshops and topic discussions, and quality improvement projects. In addition to supporting the interns' academic and professional growth, this program also furthered the mission of SHAC to promote positive health outcomes for underserved populations.

SUMMARY

The SHAC Ambulatory Care in Underserved Populations Internship represents an innovative initiative by pharmacy student leaders to develop a service-focused internship for fellow student pharmacists. Participation in the internship provides unique opportunities not often available in conventional pharmacy curricula, including engagement with underserved patient populations and exploration of strategies to mitigate health disparities. Crafted by students for fellow students, this internship provides opportunities for personal and professional growth for both student developers and interns to carry into their future pharmacy careers.

Operation Naloxone: Overdose prevention service learning for student pharmacists

BACKGROUND AND PURPOSE

A service learning program for student pharmacists was developed to train other university students to respond effectively to opioid overdoses with naloxone. Assessments were analyzed to determine the effect of program participation on student pharmacists' overdose-related knowledge retention and harm reduction attitudes.

EDUCATIONAL ACTIVITY AND SETTING

Student pharmacists were invited to attend a 90-min train-the-trainer seminar to obtain foundational knowledge regarding opioid overdose risk, symptoms, and response. Attendees were eligible to participate in a series of 10 community outreach events to educate university students. These two-hour events included a 30-min team huddle, 60-min workshop, and 30-min team debrief. Student pharmacists were asked to complete a follow-up assessment to evaluate knowledge retention and harm reduction attitudes.

FINDINGS AND DISCUSSION

Responses from students who participated in community outreach events (intervention) were compared to those who only attended the train-the-trainer seminar (control). A total of 116 subjects attended a train-the-trainer seminar and 94 completed the follow-up assessment. Thirty-six subjects voluntarily participated in at least one community outreach event while 58 did not participate. The intervention group demonstrated superior knowledge retention compared to the control group (p < 0.001). Cumulative harm reduction attitudes did not differ between groups (p = 0.89). The intervention group exhibited more positive attitudes regarding naloxone access for individuals who use illicit opioids (p = 0.015).

SUMMARY

The Operation Naloxone service learning program enabled student pharmacists to engage with their community while reinforcing overdose-related knowledge. Student pharmacists exhibited progressive attitudes regarding harm reduction interventions.

A focus group study of chiropractic students following international service learning experiences

OBJECTIVE

One objective of chiropractic education is to cultivate clinical confidence in novice practitioners. The purpose of this qualitative study was to describe how participation in a short-term international service learning experience changed perceptions of clinical confidence in senior chiropractic students.

METHODS

Seventeen senior chiropractic students participated in 4 moderated focus group sessions within 4 months after a clinical educational opportunity held in international settings. Participants answered standard questions on how this educational experience may have changed their clinical confidence. Two investigators performed qualitative thematic analysis of the verbatim transcripts to identify core concepts and supporting themes.

RESULTS

The core concept was transformation from an unsure student to a confident doctor. The service learning experience allowed students to deliver chiropractic treatment to patients in a real-world setting, engage in frequent repetitions of technical skills, perform clinical decision-making and care coordination, and communicate with patients and other health professionals. Students described increased clinical confidence in 9 competency areas organized within 3 domains: (1) chiropractic competencies including observation, palpation, and manipulation; (2) clinical competencies including problem solving, clinic flow, and decision-making; and (3) communication competencies, including patient communication, interprofessional communication, and doctor-patient relationship. Students recommended that future service learning programs include debriefing sessions similar to the experience offered by these focus groups to enhance student learning.

CONCLUSION

Senior chiropractic students who participated in an international service learning program gained confidence and valuable practical experience in integrating their chiropractic, clinical, and communication skills for their future practices.

AdvoCaring: A Cocurricular Program to Provide Advocacy and Caring to Underserved Populations in Baltimore

Objective. To incorporate direct patient care and service components throughout a 4-year pharmacy program to enable students to apply knowledge learned in the classroom and develop the human and caring dimensions of Fink's Taxonomy of Significant Learning. Design. Groups of 10-12 students and a faculty advisor partnered with a local agency serving an underserved population of the greater Baltimore area to provide seven hours of service per student each semester. Activities were determined based on students' skills and agency needs. Assessment. Over 10 000 hours of care were provided from fall 2009 through spring 2014 for clients at 12 partner agencies. Student feedback was favorable. Conclusion. Cocurricular learning enables students to use their skills to benefit local communities. Through an ongoing partnership, students are able to build on experiences and sustain meaningful care initiatives.

An Assessment of Service-Learning in 34 US Schools of Pharmacy Follow Up on the 2001 Professional Affairs Committee Report

Objective. To determine if the service-learning components used at a convenience sample of schools and colleges of pharmacy meet the intent of the 2001 AACP Professional Affairs Committee (PAC) report. Methods. An online questionnaire was used to survey faculty members or staff involved with service-learning education at their school of pharmacy. Questions addressed aspects of service-learning including types of activities used, duration of student involvement with community partners, and association of learning objectives with service-learning activities. Results. The majority (85.3%) of respondents reported their institution used service-learning. Activities reported as part of service-learning ranged from working at health fairs to involvement with pharmacy school recruitment. More than half (64.3%) of service-learning activities involved long-term interactions with one community partner, and 74.1% of respondents indicated there was always an opportunity for student reflection on the service-learning activity. Conclusion. There is increasing though inconsistent application of PAC guidelines regarding service-learning.

Incorporating hypertensive patient education on salt intake into an introductory pharmacy practice experience

OBJECTIVE

To evaluate the impact of the Salt Education Program for hypertensive adults on student pharmacists' knowledge, behaviors, and attitudes regarding sodium consumption.

DESIGN

As part of the introductory pharmacy practice experience program in community pharmacies, student pharmacists assessed patients' sodium intake knowledge and behaviors, taught them how to read nutrition labels, and obtained information about their hypertensive conditions. Students completed pre-and post-intervention questionnaires in April and August 2012, respectively.

ASSESSMENT

One hundred thirty student pharmacists (70% female, 78% white) completed pre- and post-intervention questionnaires. Students demonstrated significant improvements in knowledge scores (p<0.001) and perceived benefit of a low-salt diet (p=0.004). Further, there were significant improvements in the self-reported frequency of looking at sodium content of foods when shopping (p<0.001) and purchasing low-salt foods (p=0.004).

CONCLUSION

Changes in students' knowledge, behaviors, and attitudes after participating in the Salt Education program suggested that the program was effective in improving student knowledge, behaviors, and attitudes.